Saint Louis, MO Gateway Medical

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Tips & Advice

What is a DME claim?

A durable medical equipment (DME) claim is a form you fill out to get reimbursed for expenses that you paid for and are covered by insurance. If you bought something directly from the supplier, and it qualifies, you can be reimbursed by Medicaid insurance.

Which medical supplies are covered through Medicaid?

Medicaid will cover necessary durable medical equipment that your doctor prescribes for your in-home use. They must be durable, used for a medical reason, not typically useful to someone who isn’t sick or injured (like crutches or a wheelchair), is used in the home, and has a minimum of a three-year life expectancy. If your condition has extenuating circumstances, you can file a claim or speak to a Medicaid rep to discuss your options.

What are consumable medical supplies?

Consumable medical supplies are either disposable, or unable to withstand repeated use. They are items that get used up, and generally fall into the categories of bandages, antiseptics, and skin preparations. These are usually one-off products that cannot be reused.

Are medical supplies covered by insurance?

Most insurance companies and policies cover equipment that is prescribed by a doctor to treat or assist a patient in need. There can be exceptions and coverage might not necessarily be 100%, so the only way to know for sure r is to consult your policy or insurance rep. Most items of real need are covered. Supplemental insurance can offset many costs not covered by a standard policy. The good news is that if a doctor prescribed it, you are likely covered.

What is durable medical equipment?

There are two main types of medical equipment: disposable and durable. Durable medical equipment provides therapeutic benefits to a patient who is in need because of an illness or medical condition. Durables are usually reusable items, including beds, wheelchairs, breathing machines, canes or crutches, and monitors.

Do medical centers provide specialty care?

Academic medical centers provide the widest range of specialty care treatments, including the latest technological advances, clinical trials, and surgical techniques. In general, an academic medical center is a better choice than a community hospital for complicated treatments or rare diseases. Pediatric intensive care, especially, is usually performed at academic medical centers.

What are the types of specialists found at academic medical centers?

Academic medical centers offer a broad range of specialized services, from allergists to urologists. Some of the larger medical centers have entire hospitals or clinics focused on a particular medical service, such as cancer treatment, though specialties vary among the centers. Patients whose community hospital or local doctors do not have the facilities or expertise to address complex medical conditions can be referred by their primary care physician or local specialist to a major medical center (there are more than a dozen in the United States).

Do medical centers offer outpatient services?

Yes. In addition to their inpatient hospital services, medical centers can offer a wide variety of outpatient services, such as pain clinics, rehabilitation centers, surgery, imaging and laboratory, mental health treatment, and outpatient cancer treatment. Medical groups – doctors in private practice but affiliated with the medical center--will also have offices within the medical center.

Very unprofessional, rude, does not like questions & needs to work on his bedside manners especially if he is going to see elderly patients! I cannot believe how he talks to his patients & their family members, he should be ashamed of himself!

Awesome staff who worked me in on the same day as a new patient with hives. Dr. Onder was very professional and a true caregiver. He spent time with me and really listened to me. I was never rushed and left with a great feeling that I had finally found a doctor who was able and happy to help me. Thanks!!

Incompetent at billing. Push extraordinarily expensive versions of the same drugs you can get generic for 10 bucks a month. Have two therapists on staff one of whom disappeared for weeks. Group therapy, 4 times out of 5 was me and one therapist. Lose payments. Want frequent urine tests that they send out for no reason since they get results immediately that bill insurance $3600 a pop (no joke). Change their number with no notice. The list goes on and on.

Premier Care lives up to their name in professionalism, courtesy, and caring. I see three doctors within the group; all are highly skilled and are willing to spend the time with me I need to make sure I'm aware of all my treatment options, plus they are caring and considerate of me, a person, not just a patient. I would, and DO, recommend them to anyone looking for quality, peronal care.

Dr. Rich is the best physician I've had the experience to work with. I am treated with respect, and have been actively involved with my treatment and care, since 2012. I've never felt marginalized, and have been encouraged to learn as much as possible by asking questions, and discussing research.Dr. Rich is kind and engaging, with a quiet sense of humor. He is a most gifted surgeon and person, whom I would recommend to friends, family, and anyone seeking professional medical care.

I had a hernia repaired there. The doctor performed a great job, but the office is horrible. If you have Aflac they charge $20 to fill out paperwork, of which I'm being told that is illegal. Then it takes 5-10 days to fill out the papers. So if your waiting for your money to pay bills like I was you have to end up borrowing from your parents because of the bad time frame. The thing that made me mad the most was that the Dr listed my HERNIA as a sickness. Now the last time I checked you can't walk down the street and "catch" a hernia. It's not a virus. It's a tear in your abdominal wall ( caused by an injury) minor or major. So that caused me not to get paid for a whole week from Aflac. Even the underwriters at Aflac told me to tell him to change the paperwork so they could pay me, because they knew how a hernia is caused. His response was that's insurance fraud and I won't do it. This is also the same person that when I was in there for my follow up visit to get released back to work, told me that I could tell the nurse my back to work date could be when ever I wanted 1, 2, or even 3 months from that day, he didn't care. I was in there 3 weeks post op an we talked originally about going back to work 4 weeks post op, (which is what I did). I find it strange that someone so concerned with insurance fraud would even say this.

Did You Know?

Physicians and surgeons help to keep people - from infants to the elderly - as healthy as possible. These individuals provide diagnoses and treatments for a wide variety of ailments, and preventative care and early detection for more serious illnesses. Whether you love or hate going to the doctor, the fact is your physician is there to listen to your health concerns, take preventative measures against diseases and advise you on your options for staying in tip-top shape.

In 2013, there were more than 1 million doctors of medicine in the U.S., over 854,000 of which were active. Additionally, in 2012, there were about 18,000 active general surgeons in the country. It's important to know which type of physician or surgeon you need, how to choose the best one, and account for other considerations in order to stay healthy.

Different Types of Physicians

Patients can choose from a wide variety of physicians depending on doctor specialty and what problems they are experiencing. Here are a few of the most common types of physicians that you may see in your lifetime:

General Practitioner
Your GP is the doctor that you go to for regular checkups, vaccines and to identify health issues. GPs can treat many different illnesses and injuries, from the common cold to a broken arm. If your health requires a second opinion or expert care, the GP will refer you to a specialist who has the skills to focus in on the issue.

Cardiologist
Heart attacks and heart disease are some of the most common afflictions seen across the country, making cardiologists important to your long-term health. These physicians specialize in studying and treating the heart and related diseases.

Dentist
Other than a GP, the dentist is likely the most common physician you'll ever see. These professionals work with the human mouth, ensuring that your teeth and gum health are up to par. Patients typically go to the dentist twice a year.

Dermatologist
Dermatologists are focused on skin-related issues and diseases, from skin cancers, to acute acne, eczema, psoriasis, and general cosmetic concerns like aging and scars. Most will also perform annual or semi-annual mole checks to screen for any signs of melanoma, the most serious form of skin cancer.

ENT
If you have a number of sinus infections or have had your tonsils taken out, you've likely seen an ENT specialist. ENTs handle ailments related to the ear, nose and throat, often related to taking out tonsils and treating hearing issues.

OB/GYN
For many women, their gynecologist and obstetrician are the same person. These professionals work with the female reproductive system to focus on reproductive health, fertility issues, prenatal care, options for new and expectant mothers, neonatal care and childbirth. OB/GYNs can also help in the early detection of breast or cervical cancer.

Choosing a Physician

There are obviously a number of physicians that you can choose from, but how do you know if they're the best choice for you? Here are a few considerations to help you pick a physician:

Look at Your Insurance
Before you get down to the details, you need to verify which doctors are covered by your insurance and whether they are in or out of your carrier's network. Rates may be cheaper if the doc is in network – a doctor can be covered by your insurance but not necessarily in network. Out of network is typically more expensive. Doctors often add and drop plans, so it's important to ensure that your options are compatible with your insurance plan. Doing your homework will help you avoid unexpected expenses.

Check for Board Certification
Your physician should be certified through the American Board of Medical Specialties. Doctors must earn a medical degree from a qualified school, complete three to seven years of residency training, be licensed by a state medical board and pass one or more ABMS exams to be certified.

Examine the Reviews
Reviews of a doctor can reveal a lot about what your experience may be like. People may grade on staff friendliness, availability and effectiveness of treatment. Looking at these evaluations and getting recommendations from family and friends can direct you toward a physician for your needs.

Choosing a Surgeon

Surgeons can literally hold your life in their hands, and it's important to find the best one that can put you at ease and treat you effectively

Compatibility Factor
You need to feel comfortable with your surgeon. It's important to communicate your concerns and that your surgeon can respond adequately. Surgeons should be willing to go over the details of your procedure and answer any questions that you may have. They must take the time to discuss and address your worries.

Expertise Level
If you're going in for surgery, you want someone that knows what they're doing and has a high success rate. Ask how often the surgeon performs this surgery and try to find one that regularly does it. This will give you peace of mind that you're in capable hands.

Understanding Your Insurance

Your decision on a physician or surgeon can be majorly affected by the insurance plan you have. You may have insurance through employment, your spouse, your parents if you're under 26, or the marketplace if the previous options don't apply to you. It's important to understand how your insurance works to have the full picture of what you'll need to pay for.

Your insurance will have a deductible, which is the amount that you're responsible to pay for covered medical expenses. Some plans have coinsurances, where you must pay a certain percentage of the bill, and insurance will cover the rest. Co-pays state a flat rate for certain services, like paying $20 when you visit your GP or a $100 co-pay for an emergency room visit. Once you reach your out-of-pocket maximum, which will differ if you're an individual or within a family plan, your insurance may pay for 100 percent of covered medical expenses for the rest of the plan year.

If you plan to go to the doctor, need medication or have been recommended for surgery, call your insurance provider or go online to see what your plan covers. You can choose the best doctor for your needs, understand your options and prevent yourself from being blindsided by medical expenses.

Setting Your Appointment

Most doctors require a phone call for an appointment, although some may provide online scheduling as well. Be sure to have your insurance card with you when you set an appointment, and to bring it with you to the actual appointment. They need the ID numbers to verify your coverage, and will usually make a copy of the card for their files so you don't have to show it again unless your insurance changes.

When you call, let them know if you're a new patient, as this will require you to complete some paperwork for your first visit. Tell them the reason for your visit, such as your symptoms if you're feeling sick. It's also important to inform them if you have Medicaid and to find out if you need to bring anything to the visit, like current medications or medical records.

From here, the receptionist will likely ask what dates and times work best for you. During your call, it's important to be honest about your symptoms and the reason for your visit. This information will help the doctor treat you and give him or her an idea of what to expect. Your appointment may progress faster as a result, and the doctor can come prepared with a list of options to better care for you.

Risks

Doctors see a number of patients in a day, sometimes in 15-minute increments in areas where the physicians are in high demand. This can leave little time for doctors to perform thorough examinations, and they can end up missing certain problem indicators. While some problems, like a cold or flu, can be diagnosed in this time, more complex ailments require attention, which takes up time. Reviews can illuminate which doctors actively spend the necessary time with their patients and which ones are pressed against the clock to meet demand.

Surgery has some more dire risks attached to it, so be sure to talk to your surgeon about the potential issues that can come up as a result of your procedure. If a patient has a reaction to anesthesia, it can cause very serious complications, but this is an uncommon occurrence. Blood clots can be a significant problem after surgery, often caused by inactivity during recovery. Infections, numbness, scarring, swelling and death are all possible, but the likelihood of these issues will vary depending on the type of surgery you're undergoing. Talk to your doctor about your concerns and your risk potential.

Aftercare

Surgery affects people in different ways, but as you begin to emerge from anesthesia, you'll want to alert your nurse to any issues you may have. The nurse will tell you how the procedure went, what effect it will have on your condition, what to expect when you get home and how long it will take to get back to normal. If you start feeling pain, the nurse may give you medication to stop it from getting worse. When possible, it's also advised to move around to avoid blood clots from developing in your legs. This can be as simple as occasionally flexing your knee or rotating your foot.

Some surgeries are outpatient procedures, where people are released the same day. For major surgeries, patients may stay at the hospital for a few days to be monitored and address any concerns before being sent home. Discuss with your surgeon the projected length of the hospital stay and what you need to bring.

Recovery and Follow-up

Your recovery time and follow-up expectations will vary depending on your procedure. For example, you can be expected to be on your feet within a few days of having your wisdom teeth taken out, but it may be weeks before you have fully recovered from a broken foot or heart-valve surgery. Your surgeon will give you a list of things that you'll need to do during this time, including what medications to take and when you'll be able to get back to work and other activities.

Every surgery will have a follow-up call or appointment to discuss your recovery and allow you to ask any questions about unusual symptoms or changes in your overall health. If you have a major operation, like heart surgery, it's important to make regular checkups with your doctor or a specialist to ensure that everything is normal. Visiting a doctor will help deter infection and verify that everything is healing as expected. These appointments will give you peace of mind about your state of health and ensure that any issues are caught early on.